초록접수 현황
| 16F-144 | 구연 발표 |
The Fate of Abdominal Aorta after TEVAR in Chronic Debakey IIIb Aneurysms and Risk Factor Analysis : Is Residual Abdominal Aortic Dissection Stabilized after TEVAR?
Suk-Won Song¹ ,Tae hoon Kim¹, Kwang-hun Lee², Won-Ki Woo¹, Min young Baek¹, Kyung-Jong Yoo³, Bum-Koo Cho³
¹Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, ²Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, ³Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Background : Although thoracic endovascular aortic repair (TEVAR) is commonly used for chronic DeBakey IIIb (CDIIIb) aneurysms, the fate of abdominal aorta is controversial. We sought to clarify abdominal aortic expansion after TEVAR in patients with CDIIIb aneurysm.
Methods : From 2012 to 2016, 71 patients underwent TEVAR for CDIIIb aneurysm. Forty-two patients who needed additional procedures besides TEVAR were excluded. Abdominal aortic diameter was measured at 3 different levels (celiac trunk (level A), renal artery (level B) and infrarenal aorta (level C)). Aortic expansion was defined as any increase of total diameter at each levels (A, B and C). Complete thrombosis was defined as no flow at the FL of stent distal end or whole thoracic aorta.
Results : There was no in-hospital mortality. Mean follow-up duration was 27 months. Twenty-six of 29 patients (89.7%) demonstrated complete thrombosis after TEVAR. Even though complete thrombosis was achieved, 6, 19 and 17 of 26 patients demonstrated abdominal aortic expansion at level A, B and C, respectively. The mean expansion was 0.8 ± 4.4, 1.3 ± 3.4 and 2.1 ± 3.1 mm at A, B and C without difference between complete and partial thrombosis group (Figure 1). The number of intima tears was the risk factor for celiac and infrarenal aortic expansion. (p=0.029 and p=0.030, respectively).
Conclusion : Abdominal aortic expansion in CDIIIb aneurysm can be frequently recognized even after successful TEVAR. The number of intima tears is the only risk factor of abdominal dissecting aneurysmal change. We suggest abdominal aorta should be carefully evaluated and additional procedures on the FL might be needed.
Methods : From 2012 to 2016, 71 patients underwent TEVAR for CDIIIb aneurysm. Forty-two patients who needed additional procedures besides TEVAR were excluded. Abdominal aortic diameter was measured at 3 different levels (celiac trunk (level A), renal artery (level B) and infrarenal aorta (level C)). Aortic expansion was defined as any increase of total diameter at each levels (A, B and C). Complete thrombosis was defined as no flow at the FL of stent distal end or whole thoracic aorta.
Results : There was no in-hospital mortality. Mean follow-up duration was 27 months. Twenty-six of 29 patients (89.7%) demonstrated complete thrombosis after TEVAR. Even though complete thrombosis was achieved, 6, 19 and 17 of 26 patients demonstrated abdominal aortic expansion at level A, B and C, respectively. The mean expansion was 0.8 ± 4.4, 1.3 ± 3.4 and 2.1 ± 3.1 mm at A, B and C without difference between complete and partial thrombosis group (Figure 1). The number of intima tears was the risk factor for celiac and infrarenal aortic expansion. (p=0.029 and p=0.030, respectively).
Conclusion : Abdominal aortic expansion in CDIIIb aneurysm can be frequently recognized even after successful TEVAR. The number of intima tears is the only risk factor of abdominal dissecting aneurysmal change. We suggest abdominal aorta should be carefully evaluated and additional procedures on the FL might be needed.
책임저자: Suk-Won Song
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
발표자: Suk-Won Song, E-mail : Sevraphd@yuhs.ac